Our toenails thicken and harden naturally as we grow older, but this can occur at any age. When toenail thickening occurs in younger people it is most commonly due to infection or injury.
Your toenails can thicken for many reasons. These include:
- Fungal infections
Among these, a fungal nail infection onychomycosis is a common cause of thickened toenails.
There are a number of different reasons that this could occur, with the most common one being a fungal nail infection – the medical term for this being Onychomycosis. Almost 10% of the adult population in most western countries (including 35 million Americans) have a fungal nail infection on one or more of their toenails, and it’s the cause of about half of all nail related issues.
Certainly we expect to see this in long-distance runners or soccer players, but ordinary walkers are just as susceptible. The likelihood of this occurring is multiplied when mileage is increased, sneakers are too short, or walking routes with steep inclines alter the biomechanics of everyday motion.
Thickened toenails can be painful and difficult to cut, and they can increase one’s susceptibility to infection.
Another cause of thickened toenails could be a medical condition, such as diabetes. One of the side effects of diabetes is poor blood circulation, especially to the lower extremities. As a result of the poor blood flow to your toes, the skin and nails do not receive the required nutrients to grow properly. Psoriasis is another medical condition that can cause nails to thicken, and is typically characterized by areas of red, raised and flaky skin that may look like scales. This condition can cause the finger and toenails to exhibit sections of pitting, thickened growth or irregular nail contours.
The correct course of treatment for your thickened toenails is really dependent upon the underlying cause.
For all cases of thickened toenails, some careful work with nail cutters and a nail file can help to reduce the thickness of your nails and assist with the appearance – although if you don’t feel comfortable with doing this yourself, a podiatrist can also do this for you. Most will also have a mechanical tool to grind down your thick nails, which can be quicker and less painful than using a nail file at home. While this can improve the appearance of your nails, it won’t address any underlying issues.
If you have a fungal infection, you will need to be extra careful when cutting your nails, as they may split down the middle because they can become very brittle. Soaking your toes in warm water before you cut your nails can help prevent this by softening the nails and making them easier to cut. Be sure to clean any tools that you use with 70% isopropyl alcohol to prevent spreading the infection to your other toenails/fingernails or reinfecting your nails in the future.
If you have a fungal toenail infection, then there are a range of different treatments available, varying in price, effectiveness and the range of side effects that come with these medications. These range from topical antifungal creams or sprays, laser treatment or oral medications.
Trimming thickened toenails is a much more difficult task than trimming normal nails. In most cases your nail trimmer will be ineffective, and you may need a nail file or emery board and podiatry-grade nippers.
Consulting your podiatrist or primary care physician is recommended, especially for individuals with diabetes, poor circulation, or reduced sensation, or those taking anti-coagulants such as Warfarin, Coumadin, or Plavix.
The following is the recommended way to trim thick toenails:
- Soak your nails for at least ten minutes in warm, soapy water.
- Completely dry your toenails.
- Use the emery board or file.
- Trim the nails, starting at one corner and continuing straight across to the other corner. Smaller cuts with the trimmer will prevent splitting or chipping.
- One important note: do not use cuticle pushers, which disturb the natural barrier that prevents the introduction of potential pathogens.